Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
65 yo male comes to ed due to generalized weakness , fatigue .he has been smoking for about 20 years ,one pack a day.He also complains of severe back pain ,he just remmember having left rib pain in the past.Physical exam:pallor and hepatomegaly.labs:hypercalcemia.Bun 80 and creatinine:2
what is the best next step in mgt???
A-bone marrow biopsy
B- xray
C-serum inmunoelectrophoresis
D-bone biopsy
E-ANA
Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
i think is C..hypercalcemia and renal insuf.....think MM in older guy
Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
any guy who has back pain and has rib pain (specially when coughing and he feels a "pop"), think myeloma. Best next step is X-ray, most accurate tests is bone marrow biopsy.
Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
i disagree. if someone has pain in bone you don't just jump and do electrophoresis, you do an X-ray first!
Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
I agree that you don't jump to do electrophoresis with just pain, but in this case, there are so many symptoms suggesting myeloma, so C is my choice too
Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
According to mtb2 serum eletrophoresis is the most common wrong answer. The initial test is x ray and diagnostic test is bone marrow biopsy. Page 229, 231
Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
hi guys! correct answer BBBB....the first test done is usually an Xray of the affected bone that will show lytic lesions...MTB step 2 ck
